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    Exam Review

    1. The RN interprets the following external fetal monitoring strip as:
      A)
      Urgent: Maternal fever due to chorioamnionitis.
      B)
      Non-urgent: Compression due to lack of amniotic fluid.
      C)
      Urgent: Umbilical cord prolapse due to head not being engaged in the pelvic cavity.
      D)
      Non-urgent: Progression of the fetal head through the vaginal canal.
    2. While discussing labor and delivery during a prenatal visit, a primigravida asks the nurse when she should go to the hospital.The nurse's teaching was effective when the patient states that she will come when she:
      A)
      Feels increased fetal movement.
      B)
      Thinks her membranes have ruptured.
      C)
      Has contractions that are 10 minutes apart.
      D)
      Has mild abdominal or groin discomfort.
    3. The nurse knows that the third stage of labor has a high risk for which of the following complications?
      A)
      Infection.
      B)
      Fetal hypoxia.
      C)
      Deep vein thrombosis.
      D)
      Incomplete delivery of the placenta.
    4. A nurse in a prenatal clinic is teaching a client who is in her second trimester and has a new diagnosis of gestational diabetes.Which of the following statements by the client indicates that more teaching is needed?
      A)
      "I will reduce my carbohydrate intake to 35%.”.
      B)
      "I know I am at increased risk to develop type 2 diabetes.”.
      C)
      "I will increase my exercise schedule to 5 days a week.”.
      D)
      "I will take my glyburide daily with breakfast.”.
    Page 1 of 11

    Exam Review

    1. A client with type 1 diabetes mellitus is seeking preconception counseling.She has a high glycosylated hemoglobin (HgbA1c). Before trying to become pregnant, she is strongly encouraged to stabilize her blood glucose to reduce the possibility of her baby developing which of the following?
      A)
      Cardiac defects.
      B)
      Hip dysplasia.
      C)
      Necrotizing enterocolitis.
      D)
      Port wine stain.
    2. The nurse knows that which of the following interventions is not useful for induction of labor:
      A)
      Squatting and pelvic lunges.
      B)
      Amniotomy.
      C)
      Oxytocin.
      D)
      Dinoprostone.
    3. A primigravida calls the Labor & Delivery unit and tells the nurse that she is 39 weeks pregnant and that over the past few days, although her breathing has become easier, she now feels the urge to urinate more often and has more swelling in her ankles and feet.The nurse tells the client that she is experiencing what is commonly called:
      A)
      Goodell's sign.
      B)
      Lightening.
      C)
      Hegar's sign.
      D)
      Quickening.
    4. The nurse is contacting the provider regarding the client's status during active labor. Which of the following findings should the nurse report to the provider? Select the findings the nurse should report:
      (SATA)
      A)
      Gestational age is 39 weeks and 2 days.
      B)
      Vaginal examination reveals cervix dilated to 8 cm, 100% effaced, and fetal station +1.
      C)
      Uterine contractions occurring every 2 minutes, lasting 90 seconds, with strong intensity.
      D)
      Blood pressure is 162/108 mmHg.
      E)
      Birthing parent reports pain rated 7 out of 10.
      F)
      Fetal heart rate is 170 beats per minute with minimal variability.
    Page 2 of 11

    Exam Review

    1. A nurse on the labor and delivery unit is caring for a client who is having a difficult, prolonged labor with severe backache.Which of the following interventions should the nurse assist with?
      A)
      Hydration.
      B)
      Amniotomy.
      C)
      Counterpressure to the sacrum.
      D)
      Urinary catheterization.
    2. A nurse reviews assessment findings. For each assessment finding, specify if the finding is consistent with a urinary tract infection or preterm labor. Each finding may support more than one disease process.
      Urinary tract infection (UTI)Preterm labor
      Pain✓✓
      Vaginal discharge✓✓
      Temperature✓
    3. A client who is 38 weeks pregnant is being monitored for pre-eclampsia.She suddenly complains of continuous abdominal pain and vaginal bleeding.Which of the following nursing interventions should not be included in the care of this client?
      A)
      Reassure the patient that she will deliver vaginally.
      B)
      Insert an indwelling Foley catheter.
      C)
      Initiate IV therapy with Lactated Ringer's solution.
      D)
      Monitor the fetal heart tracing.
    4. A nurse admits a woman who is 38 weeks gestation and has ruptured membranes.The nurse determines that the amniotic fluid is clear and odorless.Besides notifying the provider, which of the following is the appropriate first nursing action?
      A)
      Allow the client to ambulate in the hallway to initiate labor.
      B)
      Encourage oral fluids and administer an antipyretic medication.
      C)
      Administer glucocorticoids intramuscularly.
      D)
      Check the client's temperature every 2 hours.
    Page 3 of 11

    Exam Review

    1. A nurse receives a shift report and must first assess the high-risk antenatal client who is:
      A)
      35 weeks gestation with proteinuria and vomiting.
      B)
      39 weeks gestation with urinary urgency, frequency, and burning.
      C)
      30 weeks gestation with a fasting blood sugar of 95 mg/dL and a 3-hour glucose of 120.
      D)
      34 weeks gestation with a hemoglobin of 12 mg/dL and a potassium level of 3.5 mEq/L. .
    2. A nurse is caring for several clients.The nurse should recognize that it is appropriate to administer tocolytic therapy to which of the following clients?
      A)
      A client who has a post-term pregnancy at 42 weeks of gestation.
      B)
      A client who is dilated to 7 cm and experiencing contractions every 3-4 minutes.
      C)
      A client having Braxton-Hicks contractions at 36 weeks of gestation.
      D)
      A client who is experiencing preterm labor at 32 weeks of gestation.
    3. A nurse is caring for a client who is receiving epidural analgesia during labor.Which of the following symptoms should the nurse report to the physician?
      A)
      Temperature 37.8°C (100.3°F).
      B)
      Generalized itching.
      C)
      The client reports weakness of the lower extremities.
      D)
      Fetal bradycardia.
    4. A client arrives in labor and delivery having contractions every 8-10 minutes, lasting 30 seconds, and palpated as hard.Fetal heart rate is 124-138 with good variability.Maternal vital signs are 98.4°F temp, HR 88, RR 20, BP 112/64. Membranes are intact and vaginal exam reveals: cervix is 80% effaced, 3 cm dilated, head -2 station.The nurse knows that the patient is in which stage of labor?
      A)
      First stage of labor, transition phase.
      B)
      Second stage of labor, active phase.
      C)
      Second stage of labor, latent phase.
      D)
      First stage of labor, latent phase.
    Page 4 of 11

    Exam Review

    1. A primigravida dilated to 5 cm has just received an epidural for pain.She complains of feeling lightheaded and dizzy within 10 minutes after the procedure.Her blood pressure before the procedure was 120/80 and is now 80/52. Which of the following medications is used in this situation?
      A)
      Ergonovine maleate.
      B)
      Epoetin.
      C)
      Adrenaline.
      D)
      Ephedrine.
    2. A nurse is caring for a client who is in premature labor and is receiving terbutaline.The nurse should monitor the client for which of the following adverse effects that should be reported to the provider?
      A)
      Dyspnea.
      B)
      Headaches.
      C)
      Nervousness.
      D)
      Tremors.
    3. A nurse is caring for a client who is in active labor and notes persistent late decelerations on the fetal monitor.Which of the following are the priority nursing actions? (Select all that apply.)
      A)
      Document the findings in the client's medical record.
      B)
      Notify the healthcare provider immediately.
      C)
      Administer a tocolytic medication to stop contractions.
      D)
      Reposition the client to a side-lying position.
      E)
      Administer pain medication to the client.
      F)
      Administer oxygen to the client.
    4. A nurse is caring for a client who is in active labor with 7 cm of cervical dilation and 100% effacement.The fetus is at 0 station, and the client's amniotic membranes are intact.The client suddenly states that she needs to push.Which of the following actions should the nurse take?
      A)
      Observe the perineum for signs of crowning.
      B)
      Help the client to the bathroom to void.
      C)
      Assist the client into a comfortable supine position.
      D)
      Assist the client with quick shallow breathing during the contractions.
    Page 5 of 11

    Exam Review

    1. A client arrives in labor and delivery, and the L&D primary nurse gets a report from the L&D triage nurse. How does the primary nurse interpret the following information on the client's labor: 2 cm, 60%, and -2 station?
      A)
      2 cm dilated, 60% effaced, 2 cm below the ischial spines.
      B)
      2 cm dilated, 60% effaced, 2 cm above the ischial spines.
      C)
      2 cm effaced, 60% dilated, 2 cm below the ischial spines.
      D)
      2 cm effaced, 60% dilated, 2 cm above the ischial spines.
    2. Using Leopold's Maneuvers, the fetus is found to be with its occiput facing toward the left maternal spine.The mother is complaining of increased back labor pain.The nurse knows that the fetus is in which position?
      A)
      Left occiput anterior.
      B)
      Right occiput posterior.
      C)
      Left occiput posterior.
      D)
      Right occiput anterior.
    3. A nurse is caring for a client who is in the first stage of labor.The nurse observes the umbilical cord protruding from the vagina.Which of the following actions should the nurse NOT perform?
      A)
      Take pressure off of the presenting part of the fetal head.
      B)
      Prepare the client for an immediate cesarean birth.
      C)
      Place the client in a knee-chest position.
      D)
      Attempt to gently put the cord back inside.
    4. The nurse knows that a diagnosis for gestational diabetes can be determined with which lab values?
      A)
      A 1-hour post-prandial value of 110 mg/dL.
      B)
      A 3-hour glucose tolerance test fasting value of 80 mg/dL.
      C)
      A glucose challenge test-fasting value of 100 mg/dL and 2-hour value of 130 mg/dL.
      D)
      A 3-hour glucose tolerance test-fasting value of 98 mg/dL and 3-hour value of 190 mg/dL. .
    Page 6 of 11